• 重慶醫(yī)科大學附屬第一醫(yī)院血管外科(重慶400016);

目的探討復雜的創(chuàng)傷性動脈瘤(TAA)和動靜脈瘺(TAVF)的手術方法和療效。方法對我院1963年6月至2000年12月經手術治療的TAA和TAVF 121例進行回顧性分析。結果TAA 71例含91個動脈瘤,TAVF 50例含54個動靜脈瘺。手術方式包括瘤體切除和端端吻合或血管移植或上下結扎,瘤體上下結扎加血管旁路移植,直接修補或補片。瘺管切除加四頭結扎或動靜脈移植或動靜脈修補,介入栓塞治療。死亡1例。TAA、TAVF隨訪率分別為65.7%和60.0%。遠期效果好。結論不同部位復雜的TAA和TAVF應根據(jù)其不同分型采用不同的手術方式,對選擇性病例可考慮做介入治療。

引用本文: 喬正榮,時德,戴毅,蔣鷗,王志剛. 創(chuàng)傷性動脈瘤和動靜脈瘺的術式選擇. 中國普外基礎與臨床雜志, 2004, 11(4): 314-316. doi: 復制

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7. Maloo MK, Burrows PE, Shamberger RC. Traumatic splenic arteriovenous fistula: splenic conservation by embolization [J]. J Trauma, 1999; 47(1)∶173.
8. Wang KT, Hou CJ, Hsieh JJ, et al. Late development of renal arteriovenous fistula following gunshot traumaa case report [J]. Angiology, 1998; 49(5)∶415.
9. Reber PU, Baer HU, Patel AG, et al. Superselective microcoil embolization: treatment of choice in highrisk patients with extrahepatic pseudoaneurysms of the hepatic arteries [J]. J Am Coll Surg, 1998; 186(3)∶325.
10. Sharma S, Bhargava B, Mahapatra M, et al. Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stentgraft placement [J]. Eur Radiol, 1999; 9(3)∶422.
11. Thalhammer C, Kirchherr AS, Uhlich F, et al. Postcatheterization pseudoaneurysms and arteriovenous fistulas: repair with percutaneous implantation of endovascular covered stents [J]. Radiology, 2000; 214(1)∶127.
  1. 1. 時德, 張依仁, 劉象和, 等. 創(chuàng)傷性動脈瘤和動靜脈瘺 [J]. 中華創(chuàng)傷雜志, 1996; 12(4)∶215.
  2. 2. Coldwell DM, Novak Z, Ryu RK, et al. Treatment of posttraumatic internal carotid arterial pseudoaneurysms with endovascular stents [J]. J Trauma, 2000; 48(3)∶470.
  3. 3. Luo CB, Lirng JF, Teng MM, et al. Endovascular embolization of arteriovenous fistulas of the external carotid artery [J]. Zhonghua Yi Xue Za Zhi (Taipei), 1998; 61(5)∶260.
  4. 4. Kirchgatterer A, Baldinger C, Lenglinger F, et al. Portal hypertension due to traumatic hepatic arterioportal fistula: report of successful embolization [J]. Eur J Gastroenterol Hepatol, 1998; 10(12)∶1057.
  5. 5. Balci NC, Semelka RC, Sandhu JS. Intrahepatic arterioportal fistula: gadoliniumenhanced 3D magnetic resonance angiography findings and angiographic embolization with steel coils [J]. Magn Reson Imaging, 1999; 17(3)∶475.
  6. 6. Davis KA, Fabian TC, Croce MA, et al. Improved success in nonoperative management of blunt splenic injuries: embolization of splenic artery pseudoaneurysms [J]. J Trauma, 1998; 44(6)∶1008.
  7. 7. Maloo MK, Burrows PE, Shamberger RC. Traumatic splenic arteriovenous fistula: splenic conservation by embolization [J]. J Trauma, 1999; 47(1)∶173.
  8. 8. Wang KT, Hou CJ, Hsieh JJ, et al. Late development of renal arteriovenous fistula following gunshot traumaa case report [J]. Angiology, 1998; 49(5)∶415.
  9. 9. Reber PU, Baer HU, Patel AG, et al. Superselective microcoil embolization: treatment of choice in highrisk patients with extrahepatic pseudoaneurysms of the hepatic arteries [J]. J Am Coll Surg, 1998; 186(3)∶325.
  10. 10. Sharma S, Bhargava B, Mahapatra M, et al. Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stentgraft placement [J]. Eur Radiol, 1999; 9(3)∶422.
  11. 11. Thalhammer C, Kirchherr AS, Uhlich F, et al. Postcatheterization pseudoaneurysms and arteriovenous fistulas: repair with percutaneous implantation of endovascular covered stents [J]. Radiology, 2000; 214(1)∶127.